TREATMENT SURVEY
  

At our office we are committed to providing the very best patient care. We would like to find out more about your experiences in our office. Please take a moment to fill out this questionnaire.

How satisfied are you with your orthodontic treatment? Did it measure up to your expectations?
Were you treated courteously by our staff?
What did you like most about your treatment?
What did you like least about your treatment?
Would you consider recommending our office to others?

Did you feel free to ask questions during your visits? Were your questions answered to your satisfaction?

Are there other family members who could benefit from orthodontic services?
Are there any suggestions that you could make to help us improve our services?
Thank you for your time!
Dr. Watt Bishop, Dr. Todd Gililland and Team
Patient Name (optional)